Does Auto Insurance Pay for Lost Wages? (Florida)

If you miss work as a result of an auto accident, you may be entitled to compensation for your lost wages.  This includes past and future wages, and inability to perform household services. You may also be able entitled to recover your medical expenses and pain, suffering, mental anguish, and inconvenience.  However, those damages are outside the scope of this article.

Determining who pays for your lost wages is dependent, in part, on whether you are covered by Personal Injury Protection (PIP).  Florida is one of the few states that requires most cars to have PIP.

How Much Does PIP Pay for Lost Wages?

PIP pays “60 percent of disability benefits for any loss of gross income and loss of earning capacity per individual from inability to work…caused by the injury sustained by the injured person. Florida Statutes 627.736(1)(b).

Disability benefits also cover all expenses reasonably incurred in obtaining from others ordinary and necessary services in lieu of those that, but for the injury, the injured person would have performed without income for the benefit of his or her household.”  Florida Statutes 627.736(1)(b)

All disability benefits must be paid at least every 2 weeks.

Household services include, but are not limited to, needing to hire a maid, gardener pool cleaning service or babysitter to help you if you are unable to do these tasks that you would have done but can’t do because of the injury.

First let’s take a look at your rights if you are covered by PIP.

Example #1 – PIP payable and Right to Sue

Mike, who lives in Florida, owns a motor vehicle, has auto insurance with PIP without any restrictions.

Juan crashes into Mike while Mike is driving his own auto.  Mike has $4,000 in medical bills and had $6,000 in lost wages.

(For the most part, I won’t talk too much about medical bills or pain and suffering here or in the examples below.)

While Mike had a disability as a result of this crash, he paid $500 in costs (e.g. gardener, maid, pool, cleaning service) to maintain his house.  He normally would have done this maintenance himself, but he couldn’t because he was disabled from the crash.

Mike’s PIP would pay $4,100 for disability benefits.  The breakdown is below:

Lost income: $6,000 x 60%= $3,600

Household services: $500 

Total PIP benefits for lost wages and household services = $4,100

The $4,100 in PIP benefits for disability is available to Mike while occupying any motor vehicle, or while not an occupant of a self-propelled vehicle if caused by contact with a motor vehicle.

His resident relatives would also be entitled to these benefits if they suffered this lost income and/or need for replacement services.

Mike also has a tort right (right to sue) against Juan to recover economic damages that PIP doesn’t cover.  This assumes that Juan’s negligence caused Mike’s loss of gross income and inability to perform household services.

Let’s assume that Juan was 100% negligent in causing Mike’s injuries, lost income and expenses for household services.  If this is the case, then Mike is entitled to recover $2,400 in economic damages for lost income and expenses for household services from Juan.  We arrive at $2,400 by using the formula below.

Lost income: $6,000

Household services: $500

Total PIP benefits for lost wages: –$3,900

Mike can sue for Economic Damages for Lost Wages from Juan: $2,600

This amount is usually paid by Juan’s auto insurer under its bodily injury (BI) liability coverage. This is in addition to the amount that Mike recovers from PIP.

Mike’s claim against Juan may be reduced by any collateral sources which have been paid for the benefit of the Mike, or which are otherwise available to the Mike for which a subrogation or reimbursement right does not exist. Examples of collateral sources that pay lost wages are disability income (personal or group short term and long term disability insurance).

Let’s assume that Mike had short term disability insurance that paid $2,600 for lost income as a result of this accident.  Assume that the disability insurance doesn’t have a right to recoup its payments.

In this instance, Mike cannot make a claim against Juan for the same $2,600.  This would be double dipping.  However, if Mike’s short term or long disability insurance has a right of subrogation, then Mike could make a claim against Juan for this $2,600.

Tip: You should request in writing (via certified mail return receipt) a copy of any short term or long term disability from the plan administrator, insurer and recovery agent.  Be sure to include the language in the Florida collateral source statute.  Failure of the collateral source provider to respond can jeopardize their rights.

Warning: Don’t rely on the short or long term disability insurer telling you that they have a right of subrogation or reimbursement.  They may be dead wrong.  We were able to get an approximately $50,000 short and long term disability lien waived (reduced to zero) in a claim that we settled for $300,000.

Mike may also have a claim to non-economic damages (e.g. pain and suffering, etc.) against Juan but that is outside the scope of this article.

Example #2 – PIP with Deductible

If you are covered by PIP, you have a tort right (right to sue) for the selected deductible if the other party caused your damages.  If you are partially at fault, principles of comparative fault with apply.

Let’s take the same facts as Example #1 except Mike chose a $1,000 deductible for PIP.

Mike’s PIP would pay:

Lost Wages: $6,000 – $1,000= $5,000 x .6= $3,000

Household Services: $500

Total PIP benefits = $3,500

So PIP would owe Mike $3,500 for lost wages and household services. Mike could sue Juan for the $3,000 in lost wages that PIP didn’t pay.  He could also sue Juan for medical bills (that were not paid by PIP).

Mike can also sue for non-economic damages if Mike can meet the tort threshold.  These damages will be covered by Juan’s personal auto insurer if Juan has BI liability coverage.

Who Pays Your Lost Wages if You Didn’t Have Insurance on Your Car?

Assume that you were hit by a driver who is at fault in Florida. Perhaps you were rear ended by another driver.

You miss work because of your injuries from the accident. However, you didn’t have insurance on your car.

Perhaps you forgot to pay the car insurance premium. Or maybe your mom or dad forgot to pay it.

In this scenario, the at fault driver might not owe you 100% of your lost wages. This is true even if the other driver was 100% at fault.

They may only owe you the amount that your PIP would not have paid if you had car insurance. Thus, in this instance, they may only owe you 40% of your lost wages.

As you can see, it doesn’t pay to drive without insurance. Literally.

The amount that the at fault drive owes you for lost wages will depend on which county the crash happened in. The law (for lost wages from a car accident) is different for some counties in Florida.

I wrote an article about whether the at fault driver gets a credit towards a settlement if you were uninsured. If they get a credit, it lowers the personal injury settlement amount.

The county that the accident happened in is just one of the many factors that can affect a settlement.

Who Pays Lost Wages After an Uber or Lyft Accident?

The answer depends on the state where you were injured.  It will also depend on if the Uber or Lyft was engaged in a ride when the accident happened.

I wrote a detailed article about who pays an Uber driver’s loss of income due to an accident.  

Let’s assume that someone was injured while driving for Uber or Lyft in Florida.  Let’s assume that the driver was not engaged in a ride.

In this instance, she would be entitled to 60% of her lost wages from Uber or Lyft’s PIP.

Lyft is insured with Greenwich Insurance Company.  York Risk Services Group handles Lyft’s accident claims.

Progressive insures Uber in Florida.

If another driver’s negligence caused the Uber driver’s injury, then the Uber driver can also make a claim for the remaining 40% of her lost wages.  A Lyft driver who is injured can do the same.

Example #3 – PIP and Work Accident

Richie is a Floridian who owns a motor vehicle and has auto insurance.  Richie is in the course and scope of his employment.  While driving his  employer’s vehicle, Richie gets hit when Mary runs a stop sign.  Mary failed to yield the right of way and crashed into Richie.

Richie’s employer, a police department, is self-insured for workers compensation. Richie has approximately $20,000 in medical bills, a fractured wrist and was disabled for about 15 weeks.  At the time of his accident, Richie’s average weekly wage (AWW) was $1,000.

In Florida, workers compensation is primary (pays before) PIP.

Tip: If you are injured in a motor vehicle while working, be sure to give the medical provider(s) your workers compensation insurance information.  This may speed up payment of those bills.

Worker’s compensation pays 100% of the medical bills in Florida so the injured person doesn’t owe any medical bills.  Workers compensation pays lost wages at 66 2/3% of the gross lost wage but up to a max of $842.00 per week as of January 2015.

Thus, Richie’s employer pays:

Medical Bills at 100%: $20,000

Disability/Indemnity (66 2/3% of AWW x 15 weeks): $9,999.99

Total Benefits from Workers Compensation: $29,999.99

The PIP disability (lost wage) benefit is $1,000 per week x 60% which comes out to $600 per week x 15 weeks which is $9,000.  Since WC has paid $9,999.99 and it is more than the PIP disability benefit, PIP does not owe Richie any money for disability. [However see below.]

Richie may sue Mary for the lost wages and medical expenses that PIP doesn’t pay. He may also be able to recover damages in tort against Mary for pain, suffering, mental anguish, and inconvenience if he can surpass the tort threshold.

In Richie’s claim against Mary, Mary doesn’t get to reduce the amount that she owes Richie by any workers compensation benefits that Richie received.  This is because Workers Compensation (WC) is not a collateral source, and the WC carrier has a right (subject to a formula) to recover benefits that it paid to Richie.

If Mary’s negligence caused Richie’s injuries and Richie settles the claim with Mary (usually through her auto insurer), then Richie can demand that his personal auto insurer pay the WC lien from the PIP coverage.

PIP paying Workers’ Compensation Lien (Example)

In example #3, the WC carrier paid $29,999 for medical expenses and indemnity (lost wages).  Richie settled his personal injury (tort) case against Mary’s auto insurer (Geico) for $125,000.

We demanded that State Farm, Richie’s personal auto insurer, pay $10,000 (the PIP limit) to Richie because Richie had a WC lien ($29,999.99) that was more than the PIP limits of $10,000.

Pursuant to the Manfredo formula (reduction formula), we negotiated a settlement with WC of a little over $10,000. These facts were closely based on a case that I settled for $125,000.

Warning: Don’t expect the personal PIP insurer to voluntarily pay an injured person PIP benefits (or reimburse the WC lien) if the injured person has a WC lien.  In the above case the State Farm PIP claims adjuster told me that they had never heard of PIP reimbursing an injured person (or paying WC) for the amount that WC paid.

I demanded that State Farm use its PIP coverage to pay our client (or the WC carrier) and they finally paid us.  This put another $10,000 in my client’s pocket as we didn’t take a fee on the $10,000 check because it was for PIP benefits.

How Does a Bike Rider Get His Lost Wages Paid if Hit by a Car?

Whether or not PIP pays may depend on whether the bike rider is a Florida resident.

I wrote an article about who pays a bike rider’s lost wages if a car hits her.  A lot of that article also applies if a car hits a pedestrian.  In most Florida cases, a pedestrian hit by a car is entitled to PIP benefits for lost wages.

Learn about injury settlements for pedestrians hit by a car.

Can You Ask the PIP Insurer to Reserve Your PIP for Your Lost Wages?

Yes.  This should be done in writing.  Otherwise, you may have a “He said, she said.”

The injured person can ask the PIP insurer to use PIP benefits just to pay lost wages.  He or she may want to do this if he has a big lost wage claim and Medpay.  The injured person may also want to reserve PIP to pay lost wages if he has health insurance.   (Health insurance can also be used to pay medical bills from a car accident.)

Two Florida cases say that, if asked, a PIP insurer must reserve PIP for lost wages.  In both cases, State Farm was the PIP insurer.  The cases are  Holloway v. State Farm Mut. Auto. Ins. Co., 370 So. 2d 452 (Fla. 4th DCA 1979).  Another case that agreed is Howell-Demarest v. State Farm Mut. Auto. Ins. Co., 673 So. 2d 526 (Fla. 4th DCA 1996).

Does the at fault party owe me for paid time off (PTO) that you have to use after an accident?

They may. The case that discusses this is State Farm Mut. Auto. Ins. Co. v. Egan, 626 So.2d 1076, 1078 (Fla. App. 3 Dist.1993). If the time that you used is “sick leave”, then the at fault driver does not owe you for it.

I believe that paid time off (PTO) is treated differently from sick time. Let’s assume that the time that you used is your annual leave or compensatory time that you can use for other purposes (other than sick time). In this instance, the at fault driver may owe you for this PTO.

Of course, you’ll need to show that the at fault driver was at fault in order for him to owe you for this paid time off (PTO).

Undocumented Aliens Can’t Get Lost Wages from Careless Driver

I’ve written about whether illegal immigrants can make a personal injury claim.  Here, I’m going to focus on whether illegal immigrants can make a lost wage claim.

Let’s use the prior example with Mike.

If Mike is an undocumented alien, he can’t make a claim against Juan for his past lost wages.  Veliz v. Rental Service Corp. USA, Inc., 313 F. Supp. 2d 1317 – Dist. Court, MD Florida 2003.  He may still have a claim for loss of future earnings.  Villasenor v. Martinez, 991 So.2d 433, 436 (Fla. 5th DCA 2008).

Mike can also recover damages for medical expenses but that is outside the scope of this article.

Check out some of the many Florida injury cases that we have settled, including but not limited to car accidents, slip and falls, and cruise ships accidents. We want to represent you if you were injured in an accident in Florida, on a cruise ship or boat. If you live in Florida but were injured in another state we may also be able to represent you.

Call us now at (888) 594-3577 to Get a Free Consultation.  There are No Fees or Costs Unless We Recover Money. Call us 24 hours a day, 7 days a week, and 365 days a year. We speak Spanish. We invite you to learn more about us.